Carol writes:
  Her second child gained his birth weight at
> 4 weeks of age without fussing from the peds and no supplements.  He was
> gaining an average of 4 ounces/week so that kept peds at bay.  Now he has
> only gained 2 ounces/week ...

 I am in
> the process of getting that plan of care changed to before and after
> weights
Good choice.

  To top this off, the peds are now suggesting
> that she supplement with formula
The baby may need formula supplementation at some point, but I don't think
now is the time.  More history [poops, initial wt loss, nursing frequency &
duration & quality] would be helpful.  My first instinct would be to have
mom pump with a hospital grade pump and supplement at the breast with the
expressed milk at the next breastfeeding. It would provide extra stimulation
to the breast [helpful if the baby was a 37 weeker or an inefficient nurser
for some other reason] and would not aggravate things by adding bottle
drinking to a breastfeeding experience that isn't progressing according to
plan.

> she has leaking breast and periods of fullness to indicate her need to
> nurse.
Again it would be good to know how long the baby goes between feeds.

Good luck.
Gail S. Hertz, MD, IBCLC
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